末端潜伏期指数和残余潜伏期在腕管综合征诊断中的敏感性和特异性。
Sensitivity and specificity of terminal latency index and residual latency in the diagnosis of carpal tunnel syndrome.
机构信息
Department of Neurology, School of Medicine, Dicle University, Diyarbakir, Turkey.
出版信息
Eur Rev Med Pharmacol Sci. 2011 Sep;15(9):1078-84.
OBJECTIVES
Traditionally, nerve conduction study (NCS) are used to diagnose carpal tunnel syndrome (CTS). However, no NCS has the sufficient sensitivity or specificity values to diagnose CTS by itself. Median terminal latency index (mTLI) and median residual latency (mRL) are parameters that calculated to identify abnormalities in distal segments of the median motor nerve. There are few studies on mTLI and mRL in the diagnosis of CTS. The objective of this study was to examine the sensitivity and specificity of mTLI and mRL together with NCS in the diagnosis of CTS.
PATIENTS AND METHODS AND RESULTS
The diagnostic sensitivity of mTLI and mRL were calculated and compared with the conventional NCS. Sensitivity values of electrophysiological findings were as follows: median distal sensory latency (mDSL) 91.5%, fourth finger median-ulnar sensory (M4-U4) latency difference 91.5%, mTLI 90.1%, median sensory nerve conduction velocity (mSNCV) 87.4%, and median motor distal latency (mMDL) 68.6%. Specificity values of electrophysiological findings in those with carpal tunnel syndrome were mSNCV 98.6%, mMNCV (median motor nerve conduction velocity) 98.6%, median motor wrist muscle action potential amplitude 98.6%, median sensory nerve action potential amplitude 97.4%, mSDL 97.3% and M4-U4 (fourth finger median-ulnar sensory peak latency difference) latency difference 97.3%. In all CTS patients with long mMDL values, mTLI was found to be lower, however in 22 CTS patients (22.6%) with normal mMDL, mTLI was also found to be lower. Compared with mMDL, the sensitivity of mTLI in the diagnosis of CTS was found to be higher but its specificity was lower. No differences were found in the sensitivity and specificity of mRL and mMDL. The electrophysiological findings with the highest sensitivity and specificity in diagnosing CTS among conventional NCS were mSDL, M4-U4 peak latency difference and mSNCV.
CONCLUSIONS
It was concluded that mTLI and mSDL can complete each other in the detection of abnormalities of sensory and motor fibres in the diagnosis of CTS.
目的
传统上，神经传导研究（NCS）用于诊断腕管综合征（CTS）。然而，没有任何 NCS 具有足够的敏感性或特异性值来单独诊断 CTS。正中神经末端潜伏期指数（mTLI）和正中神经残留潜伏期（mRL）是用于识别正中运动神经远端节段异常的参数。关于 mTLI 和 mRL 在 CTS 诊断中的应用研究较少。本研究旨在探讨 mTLI 和 mRL 与 NCS 联合诊断 CTS 的敏感性和特异性。
患者和方法及结果
计算并比较了 mTLI 和 mRL 的诊断敏感性与常规 NCS。电生理发现的敏感性值如下：正中神经远端感觉潜伏期（mDSL）91.5%，第四指正中-尺神经感觉潜伏期差异（M4-U4）91.5%，mTLI 90.1%，正中感觉神经传导速度（mSNCV）87.4%，正中运动神经远端潜伏期（mMDL）68.6%。有 CTS 患者电生理发现的特异性值为 mSNCV 98.6%，mMNCC（正中运动神经传导速度）98.6%，正中运动腕部肌肉动作电位幅度 98.6%，正中感觉神经动作电位幅度 97.4%，mSDL 97.3%和 M4-U4（第四指正中-尺神经感觉峰潜伏期差异）潜伏期差异 97.3%。在所有 mMDL 值较长的 CTS 患者中，发现 mTLI 较低，但在 22 例（22.6%）mMDL 正常的 CTS 患者中，也发现 mTLI 较低。与 mMDL 相比，mTLI 诊断 CTS 的敏感性更高，但特异性更低。mRL 和 mMDL 的敏感性和特异性无差异。在常规 NCS 中，诊断 CTS 敏感性和特异性最高的电生理发现是 mSDL、M4-U4 峰潜伏期差异和 mSNCV。
结论
mTLI 和 mSDL 可在检测 CTS 感觉和运动纤维异常时相互补充。
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